Objective To explore the methods of large sample research for traditional Chinese medicine(TCM) symptoms of exercise-induced diseases and to define the main symptoms and the main symptom compositon of exercise-induced diseases.Methods The methods of TCM theory of differentiation of syndrome, epidemiology study and multivariable statistical analysis were properly combined. We investigated 518 cases of exercise-induced insomnia(EII) by using the clinical epidemiology program with the uniform diagnostic standard and data processing method.Results The asthenia of both the heart and the spleen(56 cases, 10 8%) was one of the primary syndrome of EII.Conclusions This study showed that main symptoms in differential diagnosis of asthenia of both the heart and the spleen might be sleeplessness, poor appetite, excessive dream, dizziness and weakness of limb.

BACKGROUND:During the process of acute brain injury after stroke, matrix metaloproteinase can undermine the integrity of vascular basement membrane, promote the migration of neutrophils and inflammatory factors, and cause secondary brain injury. OBJECTIVE:To investigate the activation of matrix metaloproteinase 2/9 and the degradation rule of claudin in rat models of middle cerebral artery ischemia at different ischemic durations. METHODS:Thirty-nine male SD rats were randomly divided into three groups according to different ischemic durations (3, 5 and 7 hours) . Middle cerebral artery occlusion (stroke) model was established using modified suture method,i.e., separation of the external carotid artery, inserting the suture into the internal carotid artery through the external carotid artery, and eventualy reaching the middle cerebral artery. The ischemic duration in these three groups was respectively 3 , 5 and 7 hours. After 2 hours of reperfusion, Zea-Longa score and Ludmila Belayev score, brain infarct area, matrix metaloproteinase 2/9 activities and claudin 5 degradation were determined in each group. RESULTS AND CONCLUSION:With the extension of ischemic duration, brain infarct area gradualy increased, central nervous system damage gradualy aggravated, matrix metaloproteinase 2/9 activities gradualy increased, and claudin-5 expression gradualy decreased. There were significant differences between any two ischemic durations in terms of each of above-mentioned indices. The results indicate that after long duration of ischemia, the progressive damage of brain tissue can cause the gradual increase of activation of matrix metaloproteinase 2/9 and the gradual degradation of claudin 5.

Objective To compare the clinical effects of HC video laryngoscope and fiberoptic bronchoscope (FOB)in guidance of endotracheal intubation for patients undergoing cervical surgery.Meth-ods A total of 50 patients (ASA I or II)with cervical vertebra injury,nerve root cervical spondylopathy or cervical spondylotic myelopathy in the first affiliated hospital of Wenzhou medical university were selected, all of whom were undergone selective cervical operations between March 2014 and June 2015.The patients were randomly divided into two groups (n =25):HC video laryngoscope group (group H)and FOB group (group F).After induction of anesthesia,HC video laryngoscope and FOB were used for tracheal intuba-tion.⑴ Intubation time and success rates of intubation were recorded,and visual analogue scale (VAS) was used to evaluate the difficulty of intubation;⑵ Mean arterial pressure (MAP),heart rate (HR),and rate-pressure product (RPP)before incubation (Tb),immediate after intubation (T0),and 1min after in-cubation (T1)were recorded;(3)Intubation-related complications were recorded.Results ⑴ The dura-tion of intubation (19.7 ±7.1 )s in the group H was significantly shorter than that of group F (51.9 ± 19.2)s (P <0.05).The one-time success rate of intubation in group H (92%)was higher than that of group F (64%),with statistically significant differences (P <0.05).Intubation was easier in group H (P <0.05).⑵ MAP,HR and RPP of group H at T0 were higher than those of group F.And at T1,there were no statistical differences between groups in MAP,HR and RPP (P >0.05).⑶ The incidence of complications (sore throat)was lower in group H (P <0.05).Conclusions Compared to FOB,HC vid-eo laryngoscope-guided selective cervical operation has the characteristics of higher success rate of intubat-ion,shorter operation time,and easier operation,more stable hemodynamics and lower incidence of intuba-tion complications.Therefore,HC video laryngoscope is a safe and effective method in the intubation for pa-tients undergoing cervical surgery.

Objective To investigate the clinical efficacy of purging fu-organs traditional Chinese medicine (TCM)therapy for treatment of patients with severe pneumonia and sthenia-heat. Methods According to random number table method,71 patients with sthenia-heat of severe pneumonia were divided into a treatment group (35 cases)and a control group(36 cases). Conventional basic treatment was given to both groups,and additionally, small chengqi decoction was applied nasogastrically for the therapy in treatment group for 2 weeks. The clinical pulmonary infection score(CPIS),Marshall score,integration score of TCM syndromes and the mortalities in 28 days and 60 days were used to compare the clinical efficacy of the two groups. Results With the prolongation of treatment,the CPIS,Marshall score and integration score of syndromes in the two groups were gradually decreased. In treatment group,CPIS and Marshall scores were lower than those of control group on the 4th day ,and there were statistically significant differences(CPIS score:5.8±1.7 vs. 6.8±1.9,Marshall score:5.3±2.3 vs. 6.6±2.7,both P<0.05);the above 2 scores in treatment group were also lower than those of control group on the 7th and 14th day after treatment(7th day CPIS score:5.3±1.5 vs. 5.6±1.4,Marshall score:5.1±1.9 vs. 5.7±1.8;14th day CPIS score:3.9±1.7 vs. 4.4±2.3,Marshall score:4.2±1.9 vs. 4.9±2.5),but there were no statistically significant differences(all P>0.05). In addition,the integration scores of syndromes were significantly decreased on the 4th, 7th and 14th day in the treatment group significantly lower than those in the control group(4th day:7.6±2.3 vs. 10.6±2.7,7th day:7.4±2.5 vs. 9.2±2.1,14th day:6.1±1.9 vs. 8.3±2.4,all P<0.05). However,there were no statistically significant differences in mortality rates in 28 days and 60 days respectively between control group and treatment group(28 days:16.7% vs. 11.4%,60 days:25.0% vs. 20.3%,both P>0.05). Conclusion Purging fu-organs therapy not only can decrease the CPIS and Marshall scores of patients with sthenia-heat of severe pneumonia,but also can improve their syndromes.

Objective To investigate the expression and clinical significance of intergrin linked kinase (ILK) in pancreatic carcinoma.Methods ILK protein was detected by immunohistochemistry and Western blotting in 60 cases of pancreatic carcinoma and 32 cases of normal pancreatic tissue,and the relationship with the clinicopathological characteristics were analyzed.Results Immunohistochemistry showed ILK was expressed in cytoplasm and membrane of pancreatic carcinoma cells and the positive rate was 65% (39/60),which was significantly higher than 18.75% (6/32) of normal pancreatic tissue(P ＜0.05 ).Western blotting showed the expression of ILK in pancreatic carcinoma tissue was 303933±195116,which was significantly higher than 144613±30074 of normal pancreatic tissue(P＜0.05 ).In pancreatic carcinoma,the expression of ILK was correlated with clinical stage and lymph metastasis(P＜0.05 ),but not correlated with tumor cell differentiation(P＞0.05 ).Conclusions ILK protein was highly expressed in pancreatic carcinoma tissue and it was correlated with the degree of malignancy.

Objective To evaluate the screening effect of osteoporosis self-assessment tool for Asians (OSTA) in middle aged and elderly healthy men in Chengdu.Methods A total of 4042 healthy men aged 40 to 106 years received dual energy X-ray absorptiometry (DXA) assay,and OSTA index evaluation.Measurement sites included lumbar spine (L1-4),left femoral neck,trochanter,Ward's area,total hip and femoral shaft.All persons were classified into highosteoporosis-group (OSTA≤-4),mediumosteoporosis-group (-4 ＜ OSTA≤≤-1),low osteoporosis-group (OSTA＞-1),or the low risk-group (OSTA＞-1) and high risk-group (OSTA≤-1) by OSTA scores.T-scores were compared between different measurement sites detected by DXA.The sensitivity,specificity,Kappa value and the area under receiver operating characteristic (ROC) curve (AUC) of OSTA in screening osteoporosis were evaluated.Results The prevalence of osteopenia and osteoporosis in lumbar spine,proximal femur were gradually increased along with aging.The detection rate of osteoporosis in lumbar spine and proximal femur were 16.2％ and 24.0％ respectively in subjects aged over 80 years.OSTA index in low-risk,medium-risk group,high-risk group were 85.0％,11.0％,4.0％ respectively.The detection rate of osteoporosis in lumbar spine and proximal femur were 2.6％ and 1.6％ in low-risk group,10.4％ and 10.4％ in medium-risk group,and 29.3％ and 30.5％ in high-risk group,respectively.Taking OSTA ≤-1 as the cut-off value,the sensitivity and specificity of OSTA in screening osteoporosis in lumbar spine and femur by T-score＜-1 were 28.1％,28.7 ％,89.0％ and 92.4％ respectively,and by T-score≤-2.5 were 51.6％,63.2％,86.7％ and 86.8％ respectively.The consistency of diagnosis result between T-score and OSTA index according to the three versus two risk levels was 0.153 and 0.197 versus 0.195 and 0.243 Kappa value,respectively.The AUC of OSTA index for lumbar spine and femur by T-score＜-1 and T-score≤-2.5 were 0.689 and 0.823,and for different age groups and different measurement sites were 0.639 and 0.899 (all P＜0.001).Conclusions OSTA index has a certain ability in screening osteoporosis in men aged over 50 years.There are different screening results on osteoporosis among the different age groups.

Objective To evaluate the efficacy of the anterior approach to quadratus lumborum block in each abdominal and back region.Methods Twelve healthy volunteers of both sexes,aged 18-45 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,were enrolled in the study.Quadratus lumborum block was performed via the anterior approach under the guidance of ultrasound with 0.375％ ropivacaine 20 ml.The block was assessed by cold stimulation (ice cake) in each abdominal and back region (the right side of the body was divided into 15 regions using the anatomical landmarks on the body surface).The positive condition in each region was recorded at 30 min after administration.Results The region in which the positive rate ≤ 5％ was 0.The regions in which the positive rate ＞5％-20％ were 1 and 13 regions.The regions in which the positive rate ＞20％-50％ were 2,3 and 4 regions.The regions in which the positive rate ＞50％-70％ were 6,7 and 10 regions.The regions in which the positive rate ＞70％-＜95％ were 5,14 and 15 regions.The regions in which the positive rate ≥95％ were 8,9,11 and 12 regions.Conclusion The anterior approach to quadratus lumborum block is effective in the middle-lower region of the anterior abdominal wall on the blocked side.

Objective: To explore the relevant factors of acquired swallowing disorders in adult patients after cardiac surgery. Methods: A Jiatian water swallowing screening test was conducted for adult patients after cardiac surgery in our hospital from 2015-03 to 2015-09. There were 32 patients with acquired swallowing disorder deifned as Case group and meanwhile 420 patients without swallowing disorder at the same word deifned as Control group. Non-conditional Logistic regression analysis was applied to study the relevant factors for acquired swallowing disorders. Results: The overall incidence of acquired swallowing disorders was 7.08%. Multi Logistic regression analysis presented that duration of endotracheal intubation (OR=1.060,P<0.001), pre-operative arrhythmia (OR=2.780,P=0.019), NYHA grade (OR=1.789, P=0.033) and Euroscore (OR=1.216,P=0.040) were the relevant factors for the occurrence of acquired swallowing disorders in adult patients after cardiac surgery. Conclusion: Medical professionals should pay special attention to patients with above mentioned risk features at post-operative drinking to reduce the complications of acquired swallowing disorders.

Objective To understand the current status of medication compliance in the patients with postherpetic neuralgia (PHN)and its influencing factors.Methods The cross-sectional survey method was adopted to investigate the status quo of medi-cation compliance among PHN patients in the pain clinic of the Southwest Hospital of Army Military Medical University from Janu-ary of 2014 to March of 2015.Then the influence factors of medication compliance were analyzed by using the using the Logistic re-gression method.Results A total of 396 PHN patients were included 52.3% of patients had good medication compliance,while 47.7% had poor compliance.The univariate analysis showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimbursement,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance(P<0.05).The multivariate Logistic regression analysis results showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimburse-ment,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance.Conclusion The medication compliance in the patients with PHN is not high,there are many factors affecting the medication compliance.It is recom-mended to carry out the health education,strengthen the psychological intervention of the patients and establish the follow-up medi-cation compliance system for improving the medication compliance.

Non-small cell lung cancer (NSCLC) is a malignant tumor with rapid progress and high malignancy, accounting for 85% of all lung cancers. Treatment has shifted from traditional surgery, radiotherapy and chemotherapy to targeted therapy. Targeted therapy can prolong the survival of patients with positive driver gene fusion. With the continuous progress of biological research, targets related to NSCLC have gradually been discovered. Among the many driving genes of NSCLC, RET fusion is an important emerging target discovered in recent years. It has been confirmed to have a high incidence in non-smoking, young and low-differentiated NSCLC patients. This article reviews RET gene fusion in NSCLC, the relationship between the two and the treatment progress.